1. Stress, phobia and anxiety
VCE PSYCHOLOGY UNIT 4
Stress, phobia and anxiety
Study design dot points:
the distinctions between stress, phobia and anxiety; variation for individuals with stress, phobia and anxiety on a mental health continuum

3. Specific phobia as an anxiety disorder
Do you know anyone who is terrified of spiders or snakes? Have you ever jumped onto a chair and started screaming at the sight of a mouse? How is the stress response related to specific phobias?

4. Stress, anxiety and specific phobia
Before discussing specific phobia in detail, it is important to understand its links to stress and anxiety and to independently define these terms.

5. What is stress?
Stress is defined as the psychological and physical response to internal or external sources of tension (stressors) and arousal

6. Anxiety
Anxiety is characterised by feelings of persistent and extreme apprehension, fear and unease, when stressors are not necessarily present.
Severe anxiety is usually accompanied by intense physiological responses e.g. heart palpitations, muscle tension, feeling shaky/hand tremors, choking sensation, dry mouth and an upset stomach
Does this sound like the fight-flight-freeze response? It is!

7. Anxiety disorders
Anxiety disorders are a group of disorders that are characterised by chronic feelings of extreme apprehension, fear, stress and unease.

8. Different types of anxiety disorders

9. Incidence of anxiety disorders
Anxiety disorders impact
1 in 6
Australians at any given time.

10. Phobia
Persistent, irrational and intense fear of a particular object or event.
Affects approximately 3% of the Australian population.
More common in women than men.
There are four categories of phobic stimuli:
> animal phobias (for example, fear of snakes, spiders, rats or dogs)
> natural environmental phobias (for example, fear of heights, storms, water or darkness)
> situation phobias (for example, fear of enclosed spaces, elevators, flying, dentists, driving, tunnels or bridges)
> blood-injection-injury phobia (for example, fear of medical procedures or of the sight of blood).

11. Specific phobias
A specific phobia is a persistent, irrational and intense fear of a particular object or event. As with anxiety, the fear response is normal, as long as a rational response to the actual situation.
Many people are frightened of spiders or snakes and experience a fear response if one crosses their path. This makes sense from an evolutionary perspective - humans are genetically wired to fear things that pose a threat to survival.
However, if that fear starts to interfere with a person’s social functioning –deliberately avoiding the distress-causing object, activity or situation to the point where it affects their day-to-day life = a specific phobia.
When faced with the feared object or event - experience acute physiological arousal – the fight-flight-freeze response – as in the case of anxiety disorders.
Extreme cases, just thinking about the phobic object can cause intense fear and anxiety.

12. Specific phobia
Exposure to the phobic stimulus triggers an involuntary anxiety response similar to a stress response.
Eg. increased heart and blood pressure, sweating, shortness of breath, dizziness, palpitations, hand tremors etc.
Criteria: Intense fear, irrational fear, avoids fear object, cannot control fear, fear interrupts daily functioning and overwhelming anxiety.
According to the DSM-IV, a diagnosis is only made if the fear has persisted for at least 6 months.
Specific phobia is a type of anxiety disorder
The physiological activation that occurs when we feel stressed is also accompanied by feelings of anxiety. Not only are stress and anxiety symptoms of specific phobia, they can also act as triggers for the condition.
Image used under license from YAYimages

13. People or social situations
Top ten phobias
Ranking
Fear of
Phobia name
% of U.S. Population 1
Public speaking
Glossophobia
74% 2
Death
Necrophobia
68% 3
Spiders
Arachnophobia
30.5% 4
Darkness
Achlutophobia
11% 5
Heights
Acrophobia
10% 6
People or social situations
Sociophobia
7.9% 7
Flying
Aerophobia
6.5% 8
Confined spaces
Claustrophobia
2.5% 9
Open spaces
Agoraphobia
2.2% 10
Thunder & lightning
Brontophobia 2%

14. Continuum
Like all physical and mental health conditions, we can think about the relative
severity of stress, anxiety and specific phobia in terms of their position along
a continuum. One model breaks this continuum up into four broad categories:
healthy, reacting, injured and disorder
Stress
Anxiety
Phobia

15. Use the spider example in the case of a specific phobia
a ‘healthy’ person may be frightened of them, but their fear is considered to be within a normal range. If they see a spider, they may simply squash it or ask a friend to catch it and release it into the garden.
A ‘reacting’ individual will do just that: physically and psychologically ‘react’ to the spider by screaming, or running away each time they see one.
If at the ‘injured’ level along the continuum, their phobic symptoms are significantly impacting their functioning.
If at the ‘disorder’ end of the spectrum, their specific phobia has affected their functioning to the point where they have a mental disorder that requires significant intervention.
On a positive note, as mental health is determined along a continuum, a specific phobia can improve with treatment so that, over time, the person could go from being ‘disordered’ to ‘healthy’.

17. Interventions: Phobia
VCE PSYCHOLOGY UNIT 4
Interventions: Phobia
Presented by Kristy Kendall
Study design dot point:
evidence-based interventions and their use for specific phobia with reference to: the use of short-acting anti-anxiety benzodiazepine agents (gamma amino butyric acid [GABA] antagonists) in the management of phobic anxiety and relaxation techniques including breathing retraining and exercise (biological); the use of cognitive behavioural therapy (CBT) and systematic desensitisation as psychotherapeutic treatments of phobia (psychological); psychoeducation for families/supporters with reference to challenging unrealistic or anxious thoughts and not encouraging avoidance behaviours (social).

18. Treating phobias Benzodiazopines & relaxation techniques Biological
Cognitive behavioural therapy & systematic desensitisation
Psychological
Psychoeducation for families
Social
Image used under license from YAYimages

19. The role of GABA
Gamma Amino Butyric Acid (GABA) has an inhibitory role - makes postsynaptic neuron less likely to fire. It regulates anxiety, arousal and sleep.
Low levels of GABA means higher levels of anxiety (not enough GABA to regulate anxiety)
Anti-anxiety drugs that mimic the effect of GABA can be used to manage simple phobic anxiety.

20. Image used under license from YAYimages

21. Benzodiazepine
Short acting anti-anxiety medications are known as benzodiazepines.
They work selectively on GABA receptors in the brain (antagonist)
Benzodiazepines can be used as sedatives and muscle relaxants.
Common medications are valium & xanax

22. Benzodiazepine

23. Learning more… Are they addictive? Can you overdose? Can you drive?
So many questions answered if you wish to explore deeper by visiting:
Watch this video to see natural remedies that act as GABA does:

24. The effect of poor breathing
Relaxation technique 1
Breathing training – replacing incorrect breathing techniques with correct ones.
The effect of poor breathing
High blood pressure
Migraines
Hyperventilation
Muscle tension
What is good practice?
Speed (8-12 times a minute)
Nose not mouth
From diaphragm
Regularity
Depth

25. Relaxation technique 2 Exercise
Produces positive chemicals (i.e. endorphins)
Uses negative chemicals produced in a stress response (ie adrenalin)
Images used under license from YAYimages

26. vicious cycle of negative thinking & feeling
Treating phobias using psychological factors
Feelings
Create behaviour
Behaviour
Creates thoughts
Thoughts
Create feelings
Cognitive Behavioural Therapy
Uses a combination of verbal and behaviour modification techniques to help people change irrational patterns of thinking that create a phobia.
Focuses on helping the person change negative thoughts and behaviours and replaces them with more positive, realistic ones.
Cognitive
Behavioural
Therapy
Helps to crack the
vicious cycle of negative thinking & feeling

27. Treating phobias using psychological factors
Systematic desensitisation
A graded experience where a sufferer is gradually exposed to phobic stimulus while using relaxation techniques
Otherwise known as graduated exposure therapy
Utilises classical conditioning principles
NS UCS = UCR
CS = CR

28. Graduated exposure
Behaviour
Fear rating
Think about a spider
Look at a photo of a spider
Look at a real spider in a closed box
Hold the box with the spider
Let a spider crawl on your desk
Let a spider crawl on your shoe
Let a spider crawl on your sleeve
Let a spider crawl on your bare arm
Image used under license from YAYimages

29. Treating phobias using social factors
Psychoeducation for families and supporters:
Challenging unrealistic thoughts (i.e. irrational fear)
Discouraging avoidance behaviours which can act as a negative reinforcer and strengthen the phobic behaviour

30. Challenging cognitive bias
Attentional bias
Tendency to selectively attend to phobia related stimuli rather than other stimuli.
Memory bias
A better recollection of phobic events and information than other information, or of negative over positive information.
Interpretative bias
Tendency to interpret non-threatening stimuli as threatening.

31. Multiple choice activity
A psychologist treated a patient who suffered a phobia of flying. During the therapy the psychologist helped the patient to identify his unhelpful thoughts about flying, and to identify other helpful and more rational thoughts about flying.
The therapy that the psychologist used was :
cognitive behavioural therapy (CBT)
systematic desensitisation.
biofeedback
flooding
(VCAA 2012 Exam Q27)

32. Multiple choice response
A psychologist treated a patient who suffered a phobia of flying. During the therapy the psychologist helped the patient to identify his unhelpful thoughts about flying, and to identify other helpful and more rational thoughts about flying.
The therapy that the psychologist used was :
cognitive behavioural therapy (CBT)
systematic desensitisation.
biofeedback
flooding
(VCAA 2012 Exam Q27)

33. Multiple choice activity
Anxiety disorders can be managed with a group of drugs known as benzodiazepines. Benzodiazepines imitate the activity of the neurotransmitter, gamma-amino butyric acid (GABA).
Benzodiazepines work by:
activating post-synaptic neurons in the brain to calm the body and reduce arousal.
activating post-synaptic neurons in the brain to activate the body and increase arousal.
inhibiting post-synaptic neurons in the brain to calm the body and reduce arousal.
inhibiting post-synaptic neurons in the brain to activate the body and increase arousal.
(VCAA 2012 Exam Q33)

34. Multiple choice response
Anxiety disorders can be managed with a group of drugs known as benzodiazepines. Benzodiazepines imitate the activity of the neurotransmitter, gamma-amino butyric acid (GABA).
Benzodiazepines work by:
activating post-synaptic neurons in the brain to calm the body and reduce arousal.
activating post-synaptic neurons in the brain to activate the body and increase arousal.
inhibiting post-synaptic neurons in the brain to calm the body and reduce arousal.
inhibiting post-synaptic neurons in the brain to activate the body and increase arousal.
(VCAA 2012 Exam Q33)

35. Fast five: Question 1
A state of physiological and psychological tension is known as what?

36. Question 1 (Response)
A state of physiological and psychological tension is known as what?
Answer:
Stress

37. Fast five: Question 2
What is the term given to fear and uneasiness that something is about to happen?

38. Question 2 (Response)
What is the term given to fear and uneasiness that something is about to happen?
Answer:
Anxiety

39. Fast five: Question 3
An intense, irrational and persistent fear is known as what?

40. Question 3 (Response)
An intense, irrational and persistent fear is known as what?
Answer:
Phobia

41. Fast five: Question 4
What kind of mental disorder is a phobia?

42. Question 4 (Response) What kind of mental disorder is a phobia?
Answer:
Anxiety

43. Fast five: Question 5
T/F: Anxiety disorders are the most commonly experienced mental disorders.

44. Question 5 (Response)
T/F: Anxiety disorders are the most commonly experienced mental disorders.
Answer:
True

45. Fast five: Question 1
What are the group of drugs called that mimic GABA in the brain?

46. Question 1 (Response)
What are the group of drugs called that mimic GABA in the brain?
Answer:
Benzodiazapine

47. Question 2 (Response)
Drugs that block the brains neuortransmitters are known as what?
Answer:
Antagonist

48. Fast five: Question 2
Drugs that block the brains neuortransmitters are known as what?

49. Fast five: Question 3
Which sort of factor is CBT?

50. Question 3 (Response) Which sort of factor is CBT? Answer:
Psychological

51. Fast five: Question 4
Which learning principle is systematic desensitisation based on?

52. Question 4 (Response)
Which learning principle is systematic desensitisation based on?
Answer:
Classical conditioning

53. Fast five: Question 5
Which type of factor in treating a phobia is psychoeducation for family?

54. Question 5 (Response)
Which type of factor in treating a phobia is psychoeducation for family?
Answer:
Social